Grant Will Examine Public Health Implications of IRS Regulations

ST. LOUIS - Saint Louis University School of Public Health Professor Jason Turner, Ph.D., and School of Law Professor Jesse Goldner, J.D. have received a $150,000 grant from the Robert Wood Johnson Foundation's (RWJF) Public Health Law Research Program (PHLR) to study community benefit activities conducted by non-profit hospitals. Such activities are required to maintain their tax-exempt status. The study will focus on how these resources can best be used to improve the health of the public.

Jason Turner, Ph.D., and Jesse Goldner, J.D.

"The goal of this research is to clarify both for non-profit hospitals and the federal government, the evolving nature of community benefit - what things hospitals are currently doing and what they should be doing to maintain tax-exempt status and improve public health," Goldner said.

For years, federal and state governments have granted tax-exempt status to hospitals in exchange for services or "community benefits" aimed at improving the health of the communities in which they reside.

According to Goldner, new Internal Revenue Service (IRS) regulations will require that hospitals provide more extensive information than previously required about the benefits they are providing to the community. Using data from hospital responses to new, but preliminary, IRS reporting requirements, Goldner and Turner will document which community benefit activities are currently undertaken and which of these are considered public health activities.

Most community service provided by non-profit hospitals, according to Turner, comes in the form of charity care or medical care provided for free or well below cost. However, changes brought on by health care reform will likely impact the amount of charity care hospitals provide.

"As health care reform reduces the number of individuals without insurance, non-profit hospitals will need to shift to alternative avenues to provide community benefit to justify continued tax exemption," Turner said. "More resources will be devoted to in-kind contributions, and providing other resources to community groups and governmental agencies like local asthma consortia or local financially stressed health departments, community improvement initiatives, education of health professionals and medical research. We hope this will result in more money for lead abatement, wellness programs, or other public health priorities."

Another aim of this research is to identify where partnerships between public health providers and hospitals are beneficial, which may help reduce redundancies and waste, Turner says.

The findings of this study, which may be available as soon as May 2012, may ultimately help shape IRS policy, Goldner says.

About RWJF's Public Health Law Research ProgramThe venture is one of 13 new funded research projects that address the public health impacts of laws and regulations on issues such as lead exposure, vaccinations, emergency preparedness and the structure of state health agencies. The grants total $3,409,985 and include short-term studies of specific laws or regulations and long-term evaluations.

PHLR's aim is to promote effective regulatory, legal and policy solutions to improve public health. Since its inception, the program has funded fourteen studies and several reviews of existing scientific evidence and legal structures that impact several major public health challenges.

"We now have a significant number of studies that will help policy-makers make informed decisions in dealing with major public health challenges, such as HIV, sexually transmitted diseases, obesity, immunization, drug overdoses and flu epidemics," said Scott Burris, J.D., director of PHLR and a professor of law at Temple University in Philadelphia. "At the same time, we are also providing researchers with tools to improve research methods, such as data collection and analysis."

"The results of these studies are helping us build the evidence that policy-makers can use to understand how laws and regulations affect public health-not just laws aimed at specific public health issues," said Michelle Larkin, J.D., M.S., R.N., director of the public health team at RWJF.

About Saint Louis University School of LawSaint Louis University School of Law was founded in 1843 and is the oldest law school west of the Mississippi River. The strength of the faculty, breadth of course offerings and extensive clinical and professional skills experience provide students with a well-rounded legal education. The School of Law's rich history consists of strong connections to the community and a long tradition of public service. SLU LAW's location in the heart of the City of St. Louis, offers students unparalleled access to leading law firms, corporations, government agencies and non-profit organizations - and a unique opportunity to see the law in action. For more information, visit http://law.slu.edu/.

About Saint Louis University School of Public HealthAccredited since 1991, Saint Louis University School of Public Health remains the only accredited school of public health in Missouri. It is one of 44 fully accredited public health schools in the U.S. and the only accredited Jesuit or Catholic school in the nation.